Management of Your Multiple Sclerosis

Welcome to the Patient Facing Content Template. This has been made by students from the University of Northampton.

Original Editor - User Name Top Contributors - Katherine McBeth and Kim Jackson

Read Me First[edit | edit source]

This information is not intended to replace your healthcare professional. Please make sure you seek medical advice if you are experiencing any symptoms.

Disclaimer[edit | edit source]

The content on or accessible through Physiopedia is for informational purposes only. Physiopedia is not a substitute for professional advice or expert medical services.

What is Multiple Sclerosis?[edit | edit source]

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system in which the myelin sheath surrounding the axons of the brain and spinal cord become damaged, resulting in demyelination and scarring. When this occurs it may slow down or stop the transmission of nerve impulses.

Multiple sclerosis (MS) effects everyone differently because symptoms vary so much person to person. In addition there are four different types of MS.

Causes[edit | edit source]

The specific cause of multiple sclerosis is unknown. The most widely accepted theory is that multiple sclerosis is an autoimmune disease that preferentially destroys the CNS while the peripheral nervous system is spared.

Your immune system mistakenly attacks the nerves in your brain and spinal cord.

Possible causes
Immunologic factor
Environmental factor
Genetic factor
Infectious factor
Gut microbiome factor

Prevention[edit | edit source]

Quit smoking
Get adequate sun exposure and supplement with vitamin D
Eat a healthy diet low in saturated fat, and supplement with flaxseed oil
Keep your stress levels down and exercise regularly

Symptoms[edit | edit source]

Multiple Sclerosis will present with varying symptoms depending upon the location of the nerves being affected. Symptoms usually appear suddenly and rapidly over a period of minutes or hours, but in more rare cases the symptoms may be insidious and take several weeks to months to develop.

Central - Fatigue, Cognitive impairment, Depression, Unstable mood
Visual - Blurred vison, involuntary eye movements, double vison
Speech - Difficulty pronouncing and producing sound
Throat - Difficulty swallowing
Musculoskeletal - Spasms, Weakness, involuntary movements when walking
Sensation - Pain, numbness, Burning/prickling sensation (usually hands, arms, legs & feet)
Bowel - Incontinence, diarrhoea or constipation
Urinary - Incontinence, frequency or retention

Diagnosis[edit | edit source]

As MS is complex, diagnosis is not straight forward to diagnose.

Tests for MS could include blood tests and magnetic resonance imaging (MRI). It is also important rule out any other potential diagnosis, such as Lyme disease and vitamin B12 deficiency.

Management[edit | edit source]

An Occupational therapy can carry out an in home assessment & suggest adaptations the could help you day to day, with things like washing, dressing & moving round your home.

Relationship counselling or a sex therapist can help with changes in the dynamics of relationships and reduced interest in sex or difficulty reaching orgasm.

Your doctor may prescribe different medication to hep with your symptoms. For example Gabapentin can be used to treat muscle spasms and stiffness. Additionally Amantadine can be used to help with fatigue.

A speech and language therapist can help you overcome difficulties with speech and swallowing.

Exercises[edit | edit source]

Exercise is key for a healthy life in general. It can help to reduce the risk of life threating diseases including but not limited to cardiovascular diseases, obesity & Type-II diabetes. When you have MS it is even more important to keep moving. NHS England recommend 150 mins of exercise each week. Exercising can also help improve mood, fatigue and balance.

The best way to start exercising is to find something you enjoy. So do not be afraid to try something new. You could also try doing an activity with a friend of family member for support.

This page will give you some exercises you can do to get moving and improve some of your symptoms. You can increase the intensity over time to challenge yourself. For example you could add a weight or increase the number of sets or repetitions.

Lie on your back, with your knees bend up. Place the palms of you hand flat on the floor. till your hips back and push though you feet to lift you hips and back off the floor. (10 repetitions, 3 times)

Start in a table top position , with knees and hands on the floor. gently contract you abdominal muscles. Then raise one arm in front of you and the opposite leg behind you. (10 repetitions, 3 times)

Start with your thumb close to the opposite knee. diagonally raise your hand above your head so that it ends on the same side as the hand you are using. finishing with the thumb pointing upwards. Then slowly lower back down to the starting position. (10 repetitions, 3 times)

Sit comfortably on a chair and make sure your feet are hip width apart. lean forwards bring your weight onto your feet, squeeze you bottom to stand up. Slowly lower back to sitting. make sure you do not drop your chin and keep looking forward. (10 repetitions, 3 times)

hold a weight in your hand (this could be a can of beans), bend you elbow so that your hand moves towards you chest. Then slowly lower you hand back to the starting position. your elbow should remain by you side through out the movement. (10 repetitions, 3 times)

Self-Management[edit | edit source]

It is important to make sure you are getting enough sleep. Make sure you have a regular sleep pattern. Avoid screen time 1 hour before bed. Avoid caffeine 8 hours before bed. Make sure you do not go to bed hungry or thirsty. Finally make sure your room is dark and the are no viable clocks.

Fatigue improved by healthy sleeping patterns, exercising and planning your days and weeks so that your tasks are not all to be done on the same day.

There is currently little evidence that specific diet for MS can help. However maintaining a healthy balanced diet to improve overall wellbeing.

Stop Smoking, research suggests smoking can make your MS worse. You can get support from you doctor to do this.

More Information and Support[edit | edit source]

For more information on Multiple Sclerosis click here.

If you would like more information on the stages of Multiple Sclerosis click here.

MS Society

For UK guidance on adult exercise guidelines click here.

NHS Guidelines for MS